MAD (oral appliance) with C/APAP?

[REMmi]

1/16/25 hello, I made my 1st visit to my usual dentist for complemtary visit. As, I had heard good things about Oral Appliances, I think they are called Mandibular Advanced Devices. And have a 2nd visit scheduled where he will "make his suggestions" .

However, on a OSA podcast, from Oct, 2020 Episode 9 of Emma Cooksey with Dentist Dr. David Madow , he used a device, pre CPAP, and has concerns about what the Oral devices might do to the jaw, and teeth.

So, my thinking that maybe I could use an oral device and instead of a FFMask, use maybe nasal pillow with it.

Do people ever use both at the same time?


Any thoughts whether I should pursue the device any further? As doesn't seem to be covered by insurance, any further visits will cost out of pocket.

[DaveSkvn]

I had a MAD made about 10 years ago. It wasn't for me. Obviously to do its job it has to hold the jaw forward. Something has to take the force of the jaw trying to move back and that is the teeth. I have a couple of missing front teeth since childhood so there was a lot of stress on those that remained and they were not happy by morning. Normally your jaw will naturally drift around at night. With a MAD it will be clamped in place. I understand the benefit is proportional to how far your jaw can move forward. My jaw doesn't move forward much so there weren't many gains to be had. In the UK a private (out of pocket) MAD from a hospital orthodontist cost equivalent of $700 ten years ago. I don't regret giving it a try but you have to weigh up the costs where you are.

[SleepImprovement]

MAD didn’t seem to do much for me (and caused some pains). Tried it in conjoint with CPAP but without improvement.

[Old Steve]

You will still need the CPAP as the MAD only works on mild cases.  I would just use the CPAP with a full face mask or a nasal mask and tape my mouth.  If you are concerned about mouth breathing I doubt that the MAD device would help much with that.